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Search Results: 1 - 10 of 1724 matches for " Alison Avenell "
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Group interventions to improve health outcomes: a framework for their design and delivery
Pat Hoddinott, Karen Allan, Alison Avenell, Jane Britten
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-800
Abstract: We reviewed the wider literature on health improvement interventions delivered to patient groups and identified a gap in the literature for designing, evaluating and reporting these interventions. We drew on our experiences conducting systematic reviews, intervention, mixed method and ethnographic studies of groups for breastfeeding and weight management. A framework for health improvement group design and delivery evolved through an iterative process of primary research, reference to the literature and research team discussion.Although there is an extensive literature on group processes in education, work, politics and psychological therapies, far less is known about groups where the aim is health improvement. Theories of behaviour change which are validated for individual use are often assumed to be generalisable to group settings, without being rigorously tested. Health improvement or behaviour change interventions delivered in a group setting are complex adaptive social processes with interactions between the group leader, participants, and the wider community and environment. Ecological models of health improvement, which embrace the complex relationship between behaviour, systems and the environment may be more relevant than an individual approach to behaviour change.The evidence for effectiveness and cost-effectiveness of group compared with one-to-one interventions for many areas of health improvement in public health and primary care is weak or unknown. Our proposed framework is the first step towards advocating a more systematic approach to designing, evaluating and reporting interventions in group settings, which is necessary to improve this currently weak evidence base. This framework will enable policy makers and practitioners to be better informed about what works, how it works and in which contexts when aiming to improve health in a group setting.Groups are an alternative to individual encounters for health improvement, social support and changing beh
Systematic Review and Meta-Analysis of the Sero-Epidemiological Association between Epstein Barr Virus and Multiple Sclerosis
Yahya H. Almohmeed, Alison Avenell, Lorna Aucott, Mark A Vickers
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0061110
Abstract: Background A role for Epstein Barr virus (EBV) in multiple sclerosis (MS) has been postulated. Previous systematic reviews found higher prevalences of anti-EBV antibodies in MS patients compared to controls, but many studies have since been published, and there is a need to apply more rigorous systematic review methods. Methodology/Principal Findings We examined the link between EBV and MS by conducting a systematic review and meta-analysis of case-control and cohort studies that examined the prevalence of anti-EBV antibodies in the serum of cases and controls. We searched Medline and Embase databases from 1960 to 2012, with no language restriction. The Mantel-Haenszel odds ratios (OR) for anti-EBV antibodies sero-positivity were calculated, and meta-analysis conducted. Quality assessment was performed using a modified version of the Newcastle Ottawa scale. Thirty-nine studies were included. Quality assessment found most studies reported acceptable selection and comparability of cases and controls. However the majority had poor reporting of ascertainment of exposure. Most studies found a higher sero-prevalence of anti-EBNA IgG and anti-VCA IgG in cases compared to controls. The results for anti-EA IgG were mixed with only half the studies finding a higher sero-prevalence in cases. The meta-analysis showed a significant OR for sero-positivity to anti-EBNA IgG and anti-VCA IgG in MS cases (4.5 [95% confidence interval (CI) 3.3 to 6.6, p<0.00001] and 4.5 [95% CI 2.8 to 7.2, p<0.00001] respectively). However, funnel plot examination suggested publication bias for the reporting of the anti-EBNA IgG. No significant difference in the OR for sero-positivity to anti-EA IgG was found (1.4 [95% CI 0.9 to 2.1, p = 0.09]). Conclusion/Significance These findings support previous systematic reviews, however publication bias cannot be excluded. The methodological conduct of studies could be improved, particularly with regard to reporting and conduct of laboratory analyses.
Randomised Controlled Feasibility Trial of an Evidence-Informed Behavioural Intervention for Obese Adults with Additional Risk Factors
Falko F. Sniehotta, Stephan U. Dombrowski, Alison Avenell, Marie Johnston, Suzanne McDonald, Peter Murchie, Craig R. Ramsay, Kim Robertson, Vera Araujo-Soares
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0023040
Abstract: Background Interventions for dietary and physical activity changes in obese adults may be less effective for participants with additional obesity-related risk factors and co-morbidities than for otherwise healthy individuals. This study aimed to test the feasibility and acceptability of the recruitment, allocation, measurement, retention and intervention procedures of a randomised controlled trial of an intervention to improve physical activity and dietary practices amongst obese adults with additional obesity related risk factors. Method Pilot single centre open-labelled outcome assessor-blinded randomised controlled trial of obese (Body Mass Index (BMI)≥30 kg/m2) adults (age≥18 y) with obesity related co-morbidities such as type 2 diabetes, impaired glucose tolerance or hypertension. Participants were randomly allocated to a manual-based group intervention or a leaflet control condition in accordance to a 2:1 allocation ratio. Primary outcome was acceptability and feasibility of trial procedures, secondary outcomes included measures of body composition, physical activity, food intake and psychological process measures. Results Out of 806 potentially eligible individuals identified through list searches in two primary care general medical practices N = 81 participants (63% female; mean-age = 56.56(11.44); mean-BMI = 36.73(6.06)) with 2.35(1.47) co-morbidities were randomised. Scottish Index of Multiple Deprivation (SIMD) was the only significant predictor of providing consent to take part in the study (higher chances of consent for invitees with lower levels of deprivation). Participant flowcharts, qualitative and quantitative feedback suggested good acceptance and feasibility of intervention procedures but 34.6% of randomised participants were lost to follow-up due to overly high measurement burden and sub-optimal retention procedures. Participants in the intervention group showed positive trends for most psychological, behavioural and body composition outcomes. Conclusions The intervention procedures were found to be acceptable and feasible. Attrition rates were unacceptably high and areas for improvements of trial procedures were identified. Trial Registration Controlled-Trials.com ISRCTN90101501
Is annual surveillance of all treated hypothyroid patients necessary?
Ananth K Viswanath, Alison Avenell, Sam Philip, Shamsunder H Acharya, Graeme MacLennan, Katherine Dalziel, Olivia Pereira, Shirley A Copland, John S Bevan, Prakash Abraham
BMC Endocrine Disorders , 2007, DOI: 10.1186/1472-6823-7-4
Abstract: We carried out a retrospective analysis to see if there is evidence to support more frequent testing. We used a logistic regression model to assess whether any baseline characteristics could be applied to predict an abnormal test.We identified 2,125 patients with a minimum of 10 years follow-up (89% female, 65% autoimmune hypothyroidism, and mean age at registration 51 years). There were 2 groups: 1182 (56%) had been allocated to 18 monthly follow-up and the rest had annual surveillance. The groups were well matched at baseline. Overall, during follow-up the 12 monthly group had more abnormal tests requiring dose adjustment. However, on logistic regression analysis, people aged less than 60 years, individuals taking < 150 μg thyroxine per day and people on 18 monthly follow-up had less abnormal tests.18 monthly surveillance may be adequate in the long term follow-up of hypothyroid patients less than 60 years of age on a stable thyroxine dose of 100–150 μg/day where there are robust follow-up mechanisms in place. Implementing this strategy has potential for cost saving.Hypothyroidism is usually due to primary thyroid failure secondary to chronic autoimmune thyroiditis (Hashimoto's disease) or destructive therapy (radioactive iodine or thyroidectomy). In the United Kingdom the prevalence of overt hypothyroidism in women is at least 1.4 to 1.9% compared to less than 1% in men [1], and increases with age [2]. Levothyroxine is the standard replacement therapy and treatment is life long, with the aim of restoring patients to a euthyroid state and normalising thyroid stimulating hormone (TSH) concentration. Though the treatment of hypothyroidism is straightforward, data from several studies [3-5] show that only around 60% of patients on thyroxine replacement have normal TSH levels. Thyroxine over replacement is associated with increased risk of atrial fibrillation [6] and reduction in bone mass in postmenopausal women [7]. In addition a raised TSH level is associated with
Effect of multivitamin and multimineral supplementation on cognitive function in men and women aged 65 years and over: a randomised controlled trial
Geraldine McNeill, Alison Avenell, Marion K Campbell, Jonathan A Cook, Philip C Hannaford, Mary M Kilonzo, Anne C Milne, Craig R Ramsay, D Gwyn Seymour, Audrey I Stephen, Luke D Vale
Nutrition Journal , 2007, DOI: 10.1186/1475-2891-6-10
Abstract: The study was carried out as part of a randomised double blind placebo controlled trial of micronutrient supplementation based in six primary care health centres in North East Scotland. 910 men and women aged 65 years and over living in the community were recruited and randomised: 456 to active treatment and 454 to placebo. The active treatment consisted of a single tablet containing eleven vitamins and five minerals in amounts ranging from 50–210 % of the UK Reference Nutrient Intake or matching placebo tablet taken daily for 12 months. Digit span forward and verbal fluency tests, which assess immediate memory and executive functioning respectively, were conducted at the start and end of the intervention period. Risk of micronutrient deficiency at baseline was assessed by a simple risk questionnaire.For digit span forward there was no evidence of an effect of supplements in all participants or in sub-groups defined by age or risk of deficiency. For verbal fluency there was no evidence of a beneficial effect in the whole study population but there was weak evidence for a beneficial effect of supplementation in the two pre-specified subgroups: in those aged 75 years and over (n 290; mean difference between supplemented and placebo groups 2.8 (95% CI -0.6, 6.2) units) and in those at increased risk of micronutrient deficiency assessed by the risk questionnaire (n 260; mean difference between supplemented and placebo groups 2.5 (95% CI -1.0, 6.1) units).The results provide no evidence for a beneficial effect of daily multivitamin and multimineral supplements on these domains of cognitive function in community-living people over 65 years. However, the possibility of beneficial effects in older people and those at greater risk of nutritional deficiency deserves further attention.The suggestion that diet or nutrient supplements could delay or reduce cognitive decline in later life is consistent with the biological effects of B vitamins in lowering homocysteine levels and
Randomised trial of glutamine and selenium supplemented parenteral nutrition for critically ill patients. Protocol Version 9, 19 February 2007 known as SIGNET (Scottish Intensive care Glutamine or seleNium Evaluative Trial)
Peter JD Andrews, Alison Avenell, David W Noble, Marion K Campbell, Claire G Battison, Bernard L Croal, William G Simpson, John Norrie, Luke D Vale, Jonathon Cook, Robyn de Verteuil, Anne C Milne, The Trials Management Group
Trials , 2007, DOI: 10.1186/1745-6215-8-25
Abstract: 2 × 2 factorial, pragmatic, multicentre, double-blind, randomised controlled trial. The trial has an enrolment target of 500 patients. Inclusion criteria include: expected to be in critical care for at least 48 hours, aged 16 years or over, patients who require parenteral nutrition and are expected to have at least half their daily nutritional requirements given by that route.Allocation is to one of four iso-caloric, iso-nitrogenous groups: glutamine, selenium, both glutamine & selenium or no additional glutamine or selenium. Trial supplementation is given for up to seven days on the Intensive Care Unit and subsequent wards if practicable. The primary outcomes are episodes of infection in the 14 days after starting trial nutrition and mortality. Secondary outcomes include antibiotic usage, length of hospital stay, quality of life and cost-effectiveness.To date more than 285 patients have been recruited to the trial from 10 sites in Scotland. Recruitment is due to finish in August 2008 with a further six months follow up. We expect to report the results of the trial in summer 2009.This trial is registered with the International Standard Randomised Controlled Trial Number system. ISRCTN87144826Intensive care unit (ICU) and subsequent hospital mortality in the UK remains high, with figures of 15–20% and 30% respectively [1]. The cost per ICU bed-day exceeds £1,100 based on a mean from all trusts in England and Wales [2]. In many countries, including the UK, provision of intensive care is inadequate to meet demand. Infections acquired on the ICU have been associated with a two to three fold increased risk of death [3], this is associated with both illness and drug related impairment of the patient's immune system. Multiple portals for infection include: tracheal tubes, nasogastric tubes, chest and abdominal drains, central venous, pulmonary arterial and urinary catheters, wounds, and infective loci present before admission to ICU. These infections increase mortality, mo
A Case Study of Water Education in Australia  [PDF]
Alison J. Sammel
Creative Education (CE) , 2014, DOI: 10.4236/ce.2014.513129
Abstract:

What does it mean to be scientifically literate in relation to water? Is this understanding the same for water literacy? And what implications do these two concepts have for water education in Australia? In addressing these questions, this paper provides a snapshot of the similar and competing educational ideologies that underpin the concepts of scientific literacy in relation to water, and water literacy. An investigation of the Australian Curriculum (Science), and a small case study of pre-service education students highlight the degree to which one concept is favored over the other. This bias ultimately raises questions for water education in Australia, as it is not about whether the ACS or [future] teachers should be addressing issues associated with water, but rather how and to what end goal. This necessitates exploring the partial and political nature of any approach to educating about water, and highlights that not all approaches are equally as politically neutral or challenging.

Science as a Human Endeavour: Outlining Scientific Literacy and Rethinking Why We Teach Science  [PDF]
Alison J. Sammel
Creative Education (CE) , 2014, DOI: 10.4236/ce.2014.510098
Abstract: What does it mean to be scientifically literate? Historically, dominant understandings of scientific literacy focus on science content acquisition. However, new understandings imply more genuine and authentic interactivity between science content knowledge/skills and understanding of the economic, sociocultural, religious, ecological, ideological, political and temporal connections upon which the science is based: this is the task of Science as a Human Endeavour. This paper presents a snapshot of what Science as a Human Endeavour is, its purpose and factors to consider. Science as a Human Endeavour doesn’t just necessitate that we change our teaching practices: it forces us to rethink the teaching and learning of science and the reason why we are doing it.


Increasing Positive Perceptions of Diversity for Religious Conservative Students  [PDF]
Alison Cook, Ronda Roberts Callister
Creative Education (CE) , 2010, DOI: 10.4236/ce.2010.12014
Abstract: Evidence suggests that positive perceptions toward diversity enhance the potential group and organizational benefits resulting from diversity. Given the make-up of today’s organizations, encountering diversity has become the norm ra-ther than the exception. As such, it is becoming increasingly important to address diversity issues, and take steps to increase positive perceptions of diversity within the business classroom in order to carry that advantage into the workplace. Religious conservative students present a unique challenge to diversity education in that they likely hold value- laden attitudes that lack alignment with diversity principles. This study prescribes a scaffolding approach to increase positive perceptions of diversity within a classroom comprised predominantly of religious conservative students
Interdisciplinary Practice: Dialogue as Action to Resist Colonialism in Higher Education  [PDF]
Alison J. Sammel, Marcus Waters
Creative Education (CE) , 2014, DOI: 10.4236/ce.2014.514139
Abstract:


Two colleagues, one who is identified as a Kamilaroi First Nation of Australia man, and a woman who is identified as Australian, from European decent, come together through dialogue to explore interdisciplinary practices within their university setting. Focusing on their areas of expertise, they share the similarities and differences associated with the concepts of identity, identifying and binaries between the teaching and learning of Science Education and First Nations Knowledge production. Through emerging dialogue, they realize that even though their cultural backgrounds are completely different, both are subjected to the complexities of hegemonic binaries that impact and influence their teaching practice. In striving for equity, both authors aim to continually recognize and challenge the binaries that privilege some agendas and students, and marginalize others. By sharing assumptions, beliefs and practices, the article invites the possibility that something new can emerge from their encounter to generate innovative understandings that will inform future practice. Through their praxis and dialogues with students, both have come to understand that it is not only those students marginalized by the system that appreciate their actions, but those who are privileged also benefit as they become more aware of an ever changing world around them.


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